National Health Care Spending In 2019: Steady Growth For The Fourth Consecutive Year

Martin, Anne; Hartman, Micah; Lassman, David; Catlin, Aaron

doi:10.1377/hlthaff.2020.02022

Cited by 130 publications

(107 citation statements)

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“…11 12 Typical health expenditure levels indicate that high-income countries can also afford to do better. [11][12][13] We therefore believe that our findings constitute a call to public action, taking the steps outlined above. This is particularly urgent given documented increases in children's mental health needs since the onset of the COVID-19 pandemic-needs which are predicted to continue.…”

Section: Systematic Reviewmentioning

confidence: 99%

“…10 This is despite growing health expenditures in these countries over the years. [11][12][13] These shortfalls also persist despite longstanding recognition that all children have the right to adequate health, social and educational servicesincluding mental health services 14 -and despite considerable research evidence describing effective interventions for preventing and treating childhood mental disorders. [15][16][17] To address children's mental health needs, policymakers require pooled prevalence data from multiple high-quality epidemiological studies using current or recent diagnostic standards.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking

Barican

Yung

Schwartz

et al. 2021

Evid Based Mental Health

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QuestionMental disorders typically start in childhood and persist, causing high individual and collective burdens. To inform policymaking to address children’s mental health in high-income countries we aimed to identify updated data on disorder prevalence.MethodsWe identified epidemiological studies reporting mental disorder prevalence in representative samples of children aged 18 years or younger—including a range of disorders and ages and assessing impairment (searching January 1990 through February 2021). We extracted associated service-use data where studies assessed this. We conducted meta-analyses using a random effects logistic model (using R metafor package).FindingsFourteen studies in 11 countries met inclusion criteria, published from 2003 to 2020 with a pooled sample of 61 545 children aged 4–18 years, including eight reporting service use. (All data were collected pre-COVID-19.) Overall prevalence of any childhood mental disorder was 12.7% (95% CI 10.1% to 15.9%; I2=99.1%). Significant heterogeneity pertained to diagnostic measurement and study location. Anxiety (5.2%), attention-deficit/hyperactivity (3.7%), oppositional defiant (3.3%), substance use (2.3%), conduct (1.3%) and depressive (1.3%) disorders were the most common. Among children with mental disorders, only 44.2% (95% CI 37.6% to 50.9%) received any services for these conditions.ConclusionsAn estimated one in eight children have mental disorders at any given time, causing symptoms and impairment, therefore requiring treatment. Yet even in high-income countries, most children with mental disorders are not receiving services for these conditions. We discuss the implications, particularly the need to substantially increase public investments in effective interventions. We also discuss the policy urgency, given the emerging increases in childhood mental health problems since the onset of the COVID-19 pandemic (PROSPERO CRD42020157262).

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Section: Systematic Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking

Barican

Yung

Schwartz

et al. 2021

Evid Based Mental Health

View full text Add to dashboard Cite

show abstract

“…In the United States, healthcare spending equates to 17.7% of the approximately $21 trillion US national gross domestic product (Gross Domestic Product, 2021; Martin et al, 2021). This includes not only federally funded programs like Medicaid and Medicare but also private health insurance spending.…”

Section: Introductionmentioning

confidence: 99%

Weighted risk models for dynamic healthcare fraud detection

Rolfe

2021

Risk Manage Insurance Review

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Despite efforts to prevent it, fraud in the United States healthcare system remains a serious and pressing issue. Since healthcare fraud is a complex and multi‐faceted problem, fraud‐fighting solutions must be flexible enough to address the ever‐evolving nature of the crime. Here, we present a method to identify healthcare fraud in such a manner that incorporates both potential fraud as well as risky provider behavior. The proposed weighted risk model provides a framework for creating a dynamic fraud detection database that can be easily scaled up to incorporate emerging fraud schemes.

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“…In the calm before the pandemic storm of 2020, US healthcare spending in 2019 recorded another year of moderate growth, with an increase of 4.6% totaling $3.8 trillion, making healthcare spending 17.7% of the overall economy. 1 The healthcare segments with the greatest growth in spending in 2019 were hospital care, physician and clinical services, and retail prescription drugs. In 2019, retail prescription drug expenditures grew 5.7%, compared to increases of 3.8% and 2.2% in 2018 and 2017, respectively, and continue to constitute 9.2% of total healthcare expenditures.…”

mentioning

confidence: 99%

National trends in prescription drug expenditures and projections for 2021

Tichy

Hoffman

Suda

et al. 2021

American Journal of Health-System Pharmacy

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Purpose To report historical patterns of pharmaceutical expenditures, to identify factors that may influence future spending, and to predict growth in drug spending in 2021 in the United States, with a focus on the nonfederal hospital and clinic sectors. Methods Historical patterns were assessed by examining data on drug purchases from manufacturers using the IQVIA National Sales Perspectives database. Factors that may influence drug spending in hospitals and clinics in 2021 were reviewed—including new drug approvals, patent expirations, and potential new policies or legislation. Focused analyses were conducted for biosimilars, cancer drugs, generics, coronavirus disease 2019 (COVID-19) pandemic influence, and specialty drugs. For nonfederal hospitals, clinics, and overall (all sectors), estimates of growth of pharmaceutical expenditures in 2021 were based on a combination of quantitative analyses and expert opinion. Results In 2020, overall pharmaceutical expenditures in the United States grew 4.9% compared to 2019, for a total of $535.3 billion. Utilization (a 2.9% increase) and new drugs (a 1.8% increase) drove this increase, with price changes having minimal influence (a 0.3% increase). Adalimumab was the top drug in 2020, followed by apixaban and insulin glargine. Drug expenditures were $35.3 billion (a 4.6% decrease) and $98.4 billion (an 8.1% increase) in nonfederal hospitals and clinics, respectively. In clinics, growth was driven by new products and increased utilization, whereas in hospitals the decrease in expenditures was driven by reduced utilization. Several new drugs that will influence spending are expected to be approved in 2021. Specialty and cancer drugs will continue to drive expenditures along with the evolution of the COVID-19 pandemic. Conclusion For 2021, we expect overall prescription drug spending to rise by 4% to 6%, whereas in clinics and hospitals we anticipate increases of 7% to 9% and 3% to 5%, respectively, compared to 2020. These national estimates of future pharmaceutical expenditure growth may not be representative of any particular health system because of the myriad of local factors that influence actual spending.

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National Health Care Spending In 2019: Steady Growth For The Fourth Consecutive Year

Cited by 130 publications

References 0 publications

Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking

Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking

Weighted risk models for dynamic healthcare fraud detection

National trends in prescription drug expenditures and projections for 2021

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